A 5lb newborn with a life-threatening heart defect has received the world-first partial heart transplant using living tissue that never needs to be replaced.
North Carolina baby Owen Monroe was born with two major arteries — the aorta and pulmonary artery — fused in a condition called truncus arteriosus.
Soon after the birth, doctors avoided surgery and replaced it with living tissue that grew with it. In operations to repair the mixed valves, dead tissue is often used – but with major surgery, it needs to be replaced up to three times until adulthood and then every 10 years.
Four months after the surgery at Duke University in North Carolina, the baby is ‘growing’ and hitting every milestone.
His mother Taylor Monroe called the procedure a ‘miracle’ and said it saved her son’s life.
Truncus arteriosus is a death sentence for infants without surgery, because the heart is overworked and struggling to get nutrients to all parts of the body. It is also rare, occurring in fewer than one in 10,000 American babies.
Owen Monroe was born in North Carolina weighing 5lbs. After being told they would have to wait six months for a full transplant, the parents signed him up for partial heart surgery, which may be too long for their son.
Pictured above, Owen’s conjoined arteries are separated and the valves in his heart are being replaced.
Owen is pictured with a scar on his chest a few months after surgery
Mum Taylor says it’s a ‘miracle’ her son survived. He is ‘growing up’ and hitting every developmental milestone with his peers.
Normal Heart and Proprietary Heart: Shown above is a normal heart (left) and Owen’s (right). He had a rare condition called truncus arteriosus. Normally without surgery it is a death sentence
Parents Taylor and Nicholas Monroe said their son’s diagnosis gave them ‘few options’ as he may have suffered a heart attack shortly after birth.
They were told the waiting list for a full transplant was about six months, which their son couldn’t afford.
So they signed up for an experimental surgery at Duke University, which uses living tissue to separate fused arteries.
What is trunk arteriosus?
This rare defect is where the two main arteries of the heart – the aorta and the pulmonary artery – join together.
The disease is a death sentence for infants without surgery.
But as children grow older, they need more surgery in their lives to replace the valves – because they don’t grow with them.
What are the symptoms?
These appear in the first week of life and include
- Blue color of lips and nails;
- Shortness of breath or shortness of breath;
- Poor nutrition.
How is it treated?
Babies are treated quickly after birth to rule out heart failure, when the muscle stops working because it can’t pump enough blood to meet the body’s energy needs.
Then they will have surgery to separate the two arteries.
What is the survival rate?
About 90 percent of children who undergo surgery live beyond 40 years.
The disease is said to be rare, affecting less than one in 10,000 American children.
Source: Cincinnati Children’s Hospital
About 90 percent of children who receive the operation using tissue from a cadaver – the standard procedure – live for more than 40 years.
But they need at least three other surgeries to replace the tissue in their lives because they grow, the American Heart Association He says. It may also need to be replaced every ten years during adulthood.
When Owen was born, doctors said he had fused arteries and he was also suffering from a ‘leaky’ heart valve – which needed to be replaced.
Having good heart valves is important because they stop blood from flowing in the wrong direction.
During the operation, he received living tissue and valves from another child’s donor heart.
The heart had strong valves but was too weak to be used for a full transplant. Doctors said that without Owen, the operation would not have been used.
After Owen recovered and showed no signs of injury from the surgery, he was evacuated and returned home.
Doctors say the young man is now growing normally, and his parents couldn’t be happier.
Speaking before the birth, mum Taylor said: ‘It was basically like something had happened [at birth] We’re going to pick him up and hope for the best, which is really hard and scary to hear.
‘Nick and I have discussed Owen being a donor to other babies, which is probably the hardest conversation you can have as a parent.’
But after the surgery and her son’s recovery, Taylor said it was ‘miraculous’.
Not only is he safe, but he is thriving, which gives a lot of hope for future babies who have to go through this.
‘How pleased all the doctors are. It’s not in development at all, nothing like that.
Dr Joseph Turek, the cardiologist who led the operation, said: ‘This procedure can solve the growing problem of the valve.
‘Every time a child develops an old valve, if we can avoid multiple heart surgeries, we can extend that child’s life by a decade or more.’
During the operation, doctors cut the single artery (pictured above).
Then they used living tissue to replace the missing area of the aorta and the missing area of the pulmonary artery. New valves were added from the donor heart to control blood flow
Owen’s heart is working normally. Doctors hope that living tissue will grow with him, avoiding future heart surgeries
Dr Michael Carboni, a cardiologist at the university, added: “What’s really amazing about this process is that this innovation not only extends children’s lives, but also uses a donated heart.” If not, it cannot be replaced.
‘The valves in this procedure come from a donor heart where the tissue is too weak to be viable for a full transplant, but it has strong valves that are suitable for Owen’s needs.’
Father Mr Munro said: ‘As with our family, we knew from the start that Owen was in good hands.
‘Our biggest hope is that Owen’s success story will change the way organ donation and transplantation is offered to all patients, not just children with congenital heart disease.’